Factors associated with quality of life and weight regain 12 years after Roux-en-Y gastric bypass

Abstract

Background Scarce evidence exists in the literature about the factors influencing the long-term quality of life (QoL) and weight regain (WR) after Roux-en-Y gastric bypass (RYGB). The aim of the present study was to investigate factors associated with WR and QoL, measured by obesity specific Moorehead-Ardelt Quality of Life Questionnaire II (M-A QoLQ II), 12 years after RYGB. Methods This prospective longitudinal cohort study included 74 patients with obesity who had RYGB at the Lithuanian University of Health Sciences hospital Surgery department in 2005. Gastrointestinal and dumping symptoms, hypoglycemia, depression and anxiety disorders, hunger, satiety after meals, portion size, and grazing were assessed in the patients who agreed to participate in the study. General linear models were constructed to estimate the effect of variables on the WR and QoL. Results 12-year follow-up data were available for 50 patients (38 female, median body mass index (BMI) before surgery 42.4). The mean % excess BMI loss (%EBMIL) after 12 years was 63.1 (24.6) and the average %WR was 32.2 (19.4). The mean M-A QoLQ II score was 1.44 (1.3). Majority of the patients (76.6%) reported good or very good QoL. In multivariable analysis, only grazing (17.41% 95% CI 7.61-27.21; P = 0.001) was found to be a significant independent factor associated with WR. Factors independently associated with worse QoL were grazing (− 0.97 95% CI − 1.72, − 0.22; P = 0.013) and frequency of abdominal pain once or more per month (− 1.82 95% CI − 2.79, − 0.85; P = 0.001). Conclusion 12 years after RYGB majority of the patients report good or very good QoL and despite some WR have achieved and maintained significant weight loss. Grazing was associated with both WR and worse QoL, while the frequency of abdominal pain once or more per month was associated with only decreased QoL.

Postoperative Dumping Syndrome, Health-Related Quality of Life, Anxiety, Depression, and Eating Disturbances: Results of a Longitudinal Obesity Surgery Study

“…Partially supporting our hypothesis 2, patients with dumping syndrome showed more symptoms of post-surgery anxiety and depression, and lower post-surgery mental but not physical HRQoL than those without dumping syndrome on bivariate level (see Table 4 ). The findings on reduced mental HRQoL in patients with dumping syndrome are in accordance with previous results concerning the negative impact of dumping syndrome on patients’ HRQoL following obesity surgery [ 15 , 22 , 25 , 26 ]. More severe dumping may worsen mental HRQoL due to the unpleasant, emotionally distressing dumping symptoms and their interference with daily functioning.…”

“…Dumping syndrome may result not only in a variety of physical but also mental complaints (e.g., anxiety and depressive symptoms) [ 25 ] and reduced health-related quality of life (HRQoL) [ 12 , 15 , 22 , 25 , 26 ]. Although it may seem plausible from a clinical perspective that dumping may be associated with non-normative postoperative eating behaviors such as loss of control or addiction-like eating, this issue has been little studied.…”

Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0?

“…QOL parameters echoed the weight trends, worsening throughout follow-up and reaching pre-procedure levels. This is expected as previous literature demonstrates that weight regain is closely associated with deteriorated QOL 5 20 . The APC group, however, retained some of the improvement in the energy/fatigue scores and drove the whole-sample improvement compared to the baseline.…”

Mid-Term Outcomes of Laparoscopic Gastric Greater Curvature Plication versus Roux-en-Y Gastric Bypass: Weight Loss, Gastrointestinal Symptoms, and Health-Related Quality of Life

“…Three years after surgery, a significant difference between the procedures emerged in favour of LRYGB. One possible explanation could be the higher rate of weight regain after LGGCP, as weight regain was shown to be related to quality of life [18]. It must be noted that even lower weight loss after LGGCP had a significant impact on HRQoL.…”